Provider Demographics
NPI:1306460480
Name:GREATER HEIGHTS BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:GREATER HEIGHTS BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-317-9027
Mailing Address - Street 1:3355 S TOWN CENTER DR APT 1027
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-3001
Mailing Address - Country:US
Mailing Address - Phone:661-317-9027
Mailing Address - Fax:
Practice Address - Street 1:3355 S TOWN CENTER DR APT 1027
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3001
Practice Address - Country:US
Practice Address - Phone:661-317-9027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities